神经性厌食症患者的月经周期恢复：胰岛素样生长因子1的重要性

Menstrual cycle recovery in patients with anorexia nervosa: the importance of insulin-like growth factor 1.

作者信息

Cominato Louise, da Silva Mariana Moraes Xavier, Steinmetz Leandra, Pinzon Vanessa, Fleitlich-Bilyk Bacy, Damiani Durval

机构信息

Pediatric Endocrinology Unit, Children's Institute, Teaching Hospital of the São Paulo University Medical School, São Paulo, Brazil.

出版信息

Horm Res Paediatr. 2014;82(5):319-23. doi: 10.1159/000367895. Epub 2014 Oct 15.

DOI:10.1159/000367895

PMID:25322903

Abstract

BACKGROUND

Follow-up visits of patients recovering from anorexia nervosa (AN) have shown that some patients do not resume menstrual cycles despite returning to the normal weight for their age and height.

AIM

To verify whether leptin, insulin-like growth factor 1 (IGF-1) or another hormonal marker could be a good predictor of the return of menses.

PATIENTS AND METHODS

This prospective study included female adolescents diagnosed with AN or eating disorders not otherwise specified (EDNOS) and who were being treated in an ambulatory care unit during nutritional recovery. Body mass index and leptin, luteinizing hormone, estradiol and IGF-1 levels of these patients were evaluated. Blood samples were collected in the 1st (T1), 5th (T2), 10th (T3), 15th (T4) and 20th (T5) weeks of treatment. The hormone levels during nutritional recovery and at the time of the resumption of menses were analyzed.

RESULTS

The hormonal profiles improved after nutritional recovery, with IGF-1 correlating the most with the resumption of menses and nutritional recovery (p = 0.0001). At the resumption of menstruation, the patients showed IGF-1 levels >342.8 ng/ml.

CONCLUSION

IGF-1 was the best predictor of the return of menses in female adolescents with AN or EDNOS.

摘要

背景

对神经性厌食症（AN）康复患者的随访显示，一些患者尽管体重恢复到与其年龄和身高相应的正常水平，但月经周期仍未恢复。

目的

验证瘦素、胰岛素样生长因子1（IGF-1）或其他激素标志物是否可作为月经恢复的良好预测指标。

患者与方法

这项前瞻性研究纳入了被诊断为AN或未另行指明的进食障碍（EDNOS）的女性青少年，她们在营养恢复期间在门诊护理单元接受治疗。评估了这些患者的体重指数以及瘦素、促黄体生成素、雌二醇和IGF-1水平。在治疗的第1周（T1）、第5周（T2）、第10周（T3）、第15周（T4）和第20周（T5）采集血样。分析了营养恢复期间和月经恢复时的激素水平。